Hurt 'in the wild'

Wilderness first-aid course focuses on what to do when you're injured and far from help.

By Chuck McCollough :
November 5, 2009

Wilderness First Aid instructor Sam Coffman (far right in shorts) shows students what poison oak looks like in a field behind the Helotes Creek Nature Center. The students are (from left) Gloria Rupert, Marcia Valvo, James Hernandez (kneeling), Sara Holland-Adams, Felicia Latteo, Devin Martin and Mike Avery.

EDITOR'S NOTE: The Northwest Weekly is running a three-week series on Wilderness First Aid based on a 16-hour (two Saturdays) course taught by Sam Coffman at the Helotes Creek Nature Center. The first installment includes the definition of Wilderness First Aid and the first things to do when facing a wilderness injury or emergency. Coffman's next 16-hour Wilderness First Aid course will be Dec. 5 and 12 at the Helotes Creek Nature Center.

Wilderness First Aid is defined as being at least an hour away from definitive medical care.

But that doesn't have to be in the middle of the woods and miles from a town.

It could be in New Orleans right after Hurricane Katrina blew away the normal world of civilization.

Or New York on Sept. 11, 2001, when all emergency services were overwhelmed.

Or it could be a group of hikers in Government Canyon where one is injured and no cell phone service is available. The hikers might be only a few miles from help but are unable to phone out and forced to deal with the situation themselves.

Outdoor experts recommend that any group going into wilderness have at least one person trained in wilderness first aid and carry a first aid kit designed for the area they are traveling in.

Sam Coffman would be a good person to have on a wilderness safari because he knows his stuff.

He grew up exploring and learning about wilderness camping and the outdoors because his family spent many summers in isolated, self-supporting wilderness camps where his dad was a field geologist.

Coffman has more than 10 years of military experience as a U.S. Special Forces medic, interrogator and a linguist. He also studied botany at several outdoor schools in Colorado.

Coffman spent several years testing his own primitive living skills throughout the Rocky Mountains, often in solitary survival treks with no equipment except a knife, he said.

In addition he has been to survival-related courses, both military and civilian, and taught wilderness survival, tactics, self defense and field medicine for the military and federal and local law enforcement agencies.

At the Helotes Creek Nature Center, Hoffman had a recent class of 10 people taking the course.

The first eight-hour class dealt with diagnoses of a Wilderness First Aid situation and doing a primary and secondary survey of the patient.

"The primary survey is a rapid assessment of any life-threatening conditions for the patient. That includes checking their LOC or level of consciousness (by asking their name and where they area), ABC or airway, breathing and (blood) circulation and C-spine or cervical-spine control," Coffman said.

Students are taught to work from head-to-toe and treat as you go.

Coffman uses mnemonic terms like LOC and ABC and rhyming phrases like head-to-toe, treat as you go to help students remember what to do when giving first aid.

"The secondary survey is a re-assement of initial treatment during the primary survey while also assessing non life-threatening injuries and a brief physical exam which covers a quick check of physiological, muscular and neurological functions. It is also performed head-to-toe, treat as you go," the instructor said.

"Because of my military training, I know the best way to handle a first-aid case in the wild is to have a set pattern or plan to follow to help a caregiver's mind handle the stress of an emergency," Coffman said.

The protocol for that kind of emergency is for the caregiver to first determine if the scene is safe to treat the victim, he said.

"Making sure there is no threat to the caregiver such as bullets flying or something on fire or a wild animal .that is the first step," Coffman explained.

The next steps include primary and secondary examinations and moving the victim if necessary to a safe place for treatment.

During the primary evaluation demonstration, the instructor paired off students so one played victim and the other caregiver and then reversed roles.

"Part of the thinking in having students doing the initial and secondary examinations in front of the rest of the class is to put the caregiver student under some stress because they will be under stress in a real-life situation," Coffman said.

"We can't replicate the real-life situation but we can give them a sense of the stress of that situation," he said.